Psycho-Babble Medication Thread 913502

Shown: posts 1 to 20 of 20. This is the beginning of the thread.

 

Did I Give Parnate Enough Time?

Posted by bulldog2 on August 22, 2009, at 14:49:41

When I started parnate I was under the impression that parnate was a fast acting ad.Also read that the therapeutic range was 40-60.
I used parnate monotherapy. I started at 10 mg and increased parnate by 10 mg every 7-10 days.
I finally reached 60 mg and stayed there 2 weeks. I would say after each dose increase I would get a short ad response and than response got less. The insomnia went away and I slept okay.Anxiety decreased and I needed less klonopin.There was some hypotension with each dose increase. All in all the sides weren't bad at all.
After being on 60 mg for two weeks I gave up because I thought I was a the dose max and my response wasn't worth staying on the drug.I was on parnate eight weeks total.

Since stopping the drug I have read that parnate isn't always fast acting. I read of one doc who actually gave his patient 200 mg!!. Some p-docs use nortriptyline with the drug.

Well after my hip replacement surgery in Sept I am thinking of restarting the parnate. My p-doc always used nardil or emsam monotherapy so he wasn't well versed in parnate usage.

1. Max dose doesn't have to be 60 mg.
2. There are some tcas that can be used safely with parnate and give it a boost.

I think Coloradosnowflake's doc said you have to committ to six months.

So being that I thought the sides were mild I'd like to give parnate a whirl again.Seems like one has to be flexible and willing to stick it out with this med.Have to present my p-doc with studies showing these trials are safe.

After surgery will be on morphine with a pump and back to percocet. Don't if that combo can be used with parnate or I have to get totally off to start.

 

Re: Did I Give Parnate Enough Time?

Posted by SLS on August 22, 2009, at 15:01:02

In reply to Did I Give Parnate Enough Time?, posted by bulldog2 on August 22, 2009, at 14:49:41

Hi Bulldog.

You have a great grasp of the important aspects of using Parnate. I really have nothing else to add except that years ago, it was thought that Parnate made a particularly good drug to add lithium to.

I don't know for sure about the co-administration of Parnate and opioids. I'll see what I can find out. If anything, I would think that Parnate might reduce the dosages of Percoset needed to produce its analgesic effects.


- Scott

 

Re: Did I Give ../scott

Posted by shasling on August 22, 2009, at 15:46:17

In reply to Re: Did I Give Parnate Enough Time?, posted by SLS on August 22, 2009, at 15:01:02

Scott if you could download yahoo messagner my nick is brklyn234 i have a lot to speak to you about.

 

Re: Did I Give Parnate Enough Time? SLS

Posted by bulldog2 on August 22, 2009, at 17:47:41

In reply to Re: Did I Give Parnate Enough Time?, posted by SLS on August 22, 2009, at 15:01:02

> Hi Bulldog.
>
> You have a great grasp of the important aspects of using Parnate. I really have nothing else to add except that years ago, it was thought that Parnate made a particularly good drug to add lithium to.
>
> I don't know for sure about the co-administration of Parnate and opioids. I'll see what I can find out. If anything, I would think that Parnate might reduce the dosages of Percoset needed to produce its analgesic effects.
>
>
> - Scott

Right now I'm on 2400 mg neurontin a day plus the 40 - 60 mg percocet. After the operation I wish to ditch the percocet as soon as possible. After each dose of percocet get a quick ad bump than as it wears off get this low grade depression. I find neurontin by itself has anti-anxiety effects and some ad effects. When I tried it with parnate months ago the parnate cancelled it out and the neurontin didn't work and I stopped it.(neurontin)
P-doc thinks I am bi-polar 2. Neurontin can throw me into mania where I feel very aggressive.
Wonder if low dose lithium would help.

So with atypical depression ,bipolar 2, and adhd

1. start with parnate and nortriptyline
2. start with parnate and low dose lithium (has to be low dose to avoid side effects)
3. start with parnate,low dose nortriptyline and lithium
4. start with parnate, low dose nortriptyline and lamictal

and anything you think might get the parnate working...

Interesting thing about parnate. Raises the important neurotransmitters involved in mood...might not work by itself but gives you the material to work with if another med is needed...

 

Re: Did I Give Parnate Enough Time? bulldog2

Posted by SLS on August 22, 2009, at 18:11:18

In reply to Re: Did I Give Parnate Enough Time? SLS, posted by bulldog2 on August 22, 2009, at 17:47:41

Hi.

> Interesting thing about parnate. Raises the important neurotransmitters involved in mood...might not work by itself but gives you the material to work with if another med is needed...

I think you might be right about that. Many years ago, when I first tried Parnate, it did little for me. However, once a tricyclic (desipramine) was added, that did the trick. It was like the tricyclic finally got the support it needed to work long-term.

Understandably, people like to recommend to others what has worked for them. I have a difficult time not doing that myself. It is probably more productive to simply state what works for me and let others interpret for themselves what they would like to do with that information. That being said, I like your ideas. The only thing that I would note is that the NIH has had a great deal of success using a combination of Lamictal and lithium for bipolar disorder.

I was extremely surprised, and pleasantly so, that one our posters has a doctor who will only use Parnate when it is combined with nortriptyline.


Currently:

Parnate 80mg
nortriptyline 150mg
Lamictal 200mg
Abilify 20mg
lithium 600mg

I am still trying to find the optimal dosage of lithium. 300mg was too little. I really didn't want to waste time at 450mg, so I went right up to 600mg. If I can do just as well at 450mg, then I can experiment with that later.


- Scott

 

Re: Did I Give Parnate Enough Time?

Posted by bulldog2 on August 22, 2009, at 18:34:56

In reply to Re: Did I Give Parnate Enough Time? bulldog2, posted by SLS on August 22, 2009, at 18:11:18

> Hi.
>
> > Interesting thing about parnate. Raises the important neurotransmitters involved in mood...might not work by itself but gives you the material to work with if another med is needed...
>
> I think you might be right about that. Many years ago, when I first tried Parnate, it did little for me. However, once a tricyclic (desipramine) was added, that did the trick. It was like the tricyclic finally got the support it needed to work long-term.
>
> Understandably, people like to recommend to others what has worked for them. I have a difficult time not doing that myself. It is probably more productive to simply state what works for me and let others interpret for themselves what they would like to do with that information. That being said, I like your ideas. The only thing that I would note is that the NIH has had a great deal of success using a combination of Lamictal and lithium for bipolar disorder.
>
> I was extremely surprised, and pleasantly so, that one our posters has a doctor who will only use Parnate when it is combined with nortriptyline.
>
>
> Currently:
>
> Parnate 80mg
> nortriptyline 150mg
> Lamictal 200mg
> Abilify 20mg
> lithium 600mg
>
> I am still trying to find the optimal dosage of lithium. 300mg was too little. I really didn't want to waste time at 450mg, so I went right up to 600mg. If I can do just as well at 450mg, then I can experiment with that later.
>
>
> - Scott

Is your current dose of lithium therapeutic in the sense that if you took a blood test you would test out in the recommended range for lithium?
Or are you just looking for the dose of lithium that is synergistic with your med combo?

 

Re: Did I Give Parnate Enough Time?

Posted by doxogenic boy on August 22, 2009, at 18:54:24

In reply to Re: Did I Give Parnate Enough Time? bulldog2, posted by SLS on August 22, 2009, at 18:11:18


> nortriptyline 150mg

I tried 150 mg nortriptyline against depression in 2001. Then I took a blood test, which showed that I was three times above the therapeutic window. (I am a slow metabolizer, lacking CYP2D6). I had to go down to 50 mg to come into the therapeutic window, and then I felt better, but it didn't work sufficiently against generalized anxiety disorder.

Nortriptyline works best within its pharmaceutical window.

http://www.mayomedicallaboratories.com/test-catalog/print.php?unit_code=81858

"Numerous articles in the literature have suggested a narrow therapeutic window for this drug. Blood concentrations above or below that window correlate with poor clinical response. Mayo Clinic's experience suggests that relief from endogenous depression can be anticipated in 80% of the patients with blood concentrations within the therapeutic range.

Nortriptyline is administered at a dose of 25 mg 3 times a day to yield optimal blood levels of 50 ng/mL to 150 ng/mL.[...]"

doxogenic

 

Re: Did I Give Parnate Enough Time? bulldog2

Posted by SLS on August 22, 2009, at 19:03:14

In reply to Re: Did I Give Parnate Enough Time?, posted by bulldog2 on August 22, 2009, at 18:34:56

> > I am still trying to find the optimal dosage of lithium. 300mg was too little. I really didn't want to waste time at 450mg, so I went right up to 600mg. If I can do just as well at 450mg, then I can experiment with that later.

> Is your current dose of lithium therapeutic in the sense that if you took a blood test you would test out in the recommended range for lithium?

No.

> Or are you just looking for the dose of lithium that is synergistic with your med combo?

Yes.

LOL

I am titrating based upon response. Once I settle on a dosage, I will want to get a blood level just to see where I'm at. I'm just very curious. In order to glean the neuroprotective and neurogenic effects of lithium, the minimum blood concentration is about 0.3 ng/mL. I bet 300mg was too low to produce this level.

I think I just got lucky. We'll see. This chapter hasn't been completely written yet.


- Scott

 

Re: Did I Give Parnate Enough Time? bulldog2

Posted by Ron Hill on August 23, 2009, at 1:17:38

In reply to Did I Give Parnate Enough Time?, posted by bulldog2 on August 22, 2009, at 14:49:41

> After surgery will be on morphine with a pump and back to percocet. Don't if that combo can be used with parnate or I have to get totally off to start.

Hi Bulldog,

As you know, percocet is a combination of oxycodone and acetaminophen.

At the top of page 14 in the following document, it states that oxycodone, acetaminophen, and morphine are all okay to take with an MAOI.

http://www.psy-world.com/1008CNS_Stahl.pdf

Read the entire section of the paper that starts on page 12 and continues on to page 14. The title of the section is "MECHANISM OF DANGEROUS DRUG INTERACTIONS WITH MAIOs: COMBINING MAOIs WITH SEROTONIN REUPTAKE BLOCKADE"

The entire document is a good read with really cool diagrams. It's worth the read. It is a recent document, published in 2008.

The main author is Stephen M. Stahl, MD, PhD. Dr. Stahl is a great researcher. He's the guy that conducted the studies on Omega 3 fish oil as a tx for bipolar disorder.

If I recall correctly, the link to this article was posted on PB in the recent past. But, I can't be sure because Lamictal (lamotrigine) kills my memory.

Lastly, I recently discontinued Nardil and conducted a three month Parnate trial. The three reasons for my attempted change from Nardil to Parnate was: 1) I hoped to lose my 50 pound Nardil-induced weight gain; 2) I hoped Parnate would give me more energy that Nardil and; 3) I hoped Parnate would negate my Nardil-induced erectile dysfunction.

I did a three week washout of Nardil and ramped up quickly to 80 mg/day of Parnate. I stayed at this dosage for three months. But, it was three months of hell; ZERO energy, NO motivation, apathy, and etc. The only benefits Parnate provided was an increased libido and greatly reduced erectile dysfunction.

Like you, Bulldog, I wonder if Parnate would have started to work for me if I had stuck with the trial for several more months. But, the fact of the matter is I had no choice but to stop the trial and return to my plump friend Nardil. I had to become functional again because I was falling behind in ALL of my responsibilities.

Therefore, I did a one week washout of Parnate, restarted Nardil, and ramped my Nardil up to 90 mg/day within a week.

Ever since the Parnate withdrawal symptoms abated, I have been doing very well. I have been staying well instead of falling into my usual depressive stage associated with my bipolar ultra rapid cycling.

-- Ron

dx: Bipolar II with ultra rapid cycling (15 day cycle; six days depressed and nine days of a normal mood state) and mild OCPD

600 mg/day Trileptal
200 mg/day Lamictal
500 mg/day Keppra
90 mg/day Nardil

 

Re: Did I Give Parnate Enough Time? Ron Hill

Posted by bulldog2 on August 23, 2009, at 11:22:06

In reply to Re: Did I Give Parnate Enough Time? bulldog2, posted by Ron Hill on August 23, 2009, at 1:17:38

> > After surgery will be on morphine with a pump and back to percocet. Don't if that combo can be used with parnate or I have to get totally off to start.
>
> Hi Bulldog,
>
> As you know, percocet is a combination of oxycodone and acetaminophen.
>
> At the top of page 14 in the following document, it states that oxycodone, acetaminophen, and morphine are all okay to take with an MAOI.
>
> http://www.psy-world.com/1008CNS_Stahl.pdf
>
> Read the entire section of the paper that starts on page 12 and continues on to page 14. The title of the section is "MECHANISM OF DANGEROUS DRUG INTERACTIONS WITH MAIOs: COMBINING MAOIs WITH SEROTONIN REUPTAKE BLOCKADE"
>
> The entire document is a good read with really cool diagrams. It's worth the read. It is a recent document, published in 2008.
>
> The main author is Stephen M. Stahl, MD, PhD. Dr. Stahl is a great researcher. He's the guy that conducted the studies on Omega 3 fish oil as a tx for bipolar disorder.
>
> If I recall correctly, the link to this article was posted on PB in the recent past. But, I can't be sure because Lamictal (lamotrigine) kills my memory.
>
> Lastly, I recently discontinued Nardil and conducted a three month Parnate trial. The three reasons for my attempted change from Nardil to Parnate was: 1) I hoped to lose my 50 pound Nardil-induced weight gain; 2) I hoped Parnate would give me more energy that Nardil and; 3) I hoped Parnate would negate my Nardil-induced erectile dysfunction.
>
> I did a three week washout of Nardil and ramped up quickly to 80 mg/day of Parnate. I stayed at this dosage for three months. But, it was three months of hell; ZERO energy, NO motivation, apathy, and etc. The only benefits Parnate provided was an increased libido and greatly reduced erectile dysfunction.
>
> Like you, Bulldog, I wonder if Parnate would have started to work for me if I had stuck with the trial for several more months. But, the fact of the matter is I had no choice but to stop the trial and return to my plump friend Nardil. I had to become functional again because I was falling behind in ALL of my responsibilities.
>
> Therefore, I did a one week washout of Parnate, restarted Nardil, and ramped my Nardil up to 90 mg/day within a week.
>
> Ever since the Parnate withdrawal symptoms abated, I have been doing very well. I have been staying well instead of falling into my usual depressive stage associated with my bipolar ultra rapid cycling.
>
> -- Ron
>
> dx: Bipolar II with ultra rapid cycling (15 day cycle; six days depressed and nine days of a normal mood state) and mild OCPD
>
> 600 mg/day Trileptal
> 200 mg/day Lamictal
> 500 mg/day Keppra
> 90 mg/day Nardil
>

Are there any studies that show how nardil and parnate differ? As maois they both are supposed to destroy the enzymes that would metabolize the various neurotransmitters and thus build them up. I do know that nardil builds up gaba where parnate apparently does not.
So we have norepinephrine, serotonin and dopamine. Are there studies that show to what degree nardil and parnate build up each neurotransmitter? The fact is there must be a significant difference in the way each maoi works on the various neurotransmitters. If there wasn't a difference than most depressed people would respond equally well to either parnate or nardil. For some reason I get the feeling that nardil has a more profound effect on serotonin than parnate does.

 

Re: Did I Give Parnate Enough Time?

Posted by SLS on August 23, 2009, at 12:36:11

In reply to Re: Did I Give Parnate Enough Time? Ron Hill, posted by bulldog2 on August 23, 2009, at 11:22:06

Parnate is somewhat selective for MAO-B. It also has properties similar to amphetamine, but is about 1/10 as potent.

I don't know why someone would respond to Parnate and not Nardil and vice versa. Then again, that question can be asked of SSRIs, SNRIs, and TCAs. It might have something to do with differences in the locations of accumulation, both extracellularly and intracellularly. Just a guess.


- Scott

 

Re: Did I Give Parnate Enough Time? bulldog2

Posted by doxogenic boy on August 23, 2009, at 14:30:37

In reply to Re: Did I Give Parnate Enough Time? Ron Hill, posted by bulldog2 on August 23, 2009, at 11:22:06

> Are there any studies that show how nardil and parnate differ?
--------------
http://www.ncbi.nlm.nih.gov/pubmed/3295114

J Neural Transm Suppl. 1987;23:121-38.
MAO inhibitors in mental disease: their current status.
Dowson JH.
"[...]
Tranylcypromine also merits further investigation as clinical experience suggests that it can produce a dramatic response in some patients with phenelzine-resistant disorders. This may be due, at least in part, to its amphetamine-like effects."
+++++++++++++++++++++++

doxogenic

 

Re: Did I Give Parnate Enough Time? doxogenic boy

Posted by bulldog2 on August 23, 2009, at 14:57:38

In reply to Re: Did I Give Parnate Enough Time? bulldog2, posted by doxogenic boy on August 23, 2009, at 14:30:37

> > Are there any studies that show how nardil and parnate differ?
> --------------
> http://www.ncbi.nlm.nih.gov/pubmed/3295114
>
> J Neural Transm Suppl. 1987;23:121-38.
> MAO inhibitors in mental disease: their current status.
> Dowson JH.
> "[...]
> Tranylcypromine also merits further investigation as clinical experience suggests that it can produce a dramatic response in some patients with phenelzine-resistant disorders. This may be due, at least in part, to its amphetamine-like effects."
> +++++++++++++++++++++++
>
> doxogenic

Thanks.I understand ths amphetamine effect as I experienced it.But I see that as more of a side effect which tends to disappear as time goes on.
At least it did for me.

 

Re: Did I Give Parnate Enough Time?

Posted by SLS on August 23, 2009, at 15:02:34

In reply to Re: Did I Give Parnate Enough Time?, posted by SLS on August 23, 2009, at 12:36:11

A nice article on the use of MAOIs.

http://www.modern-psychiatry.com/new_page_23.htm


- Scott

 

Re: Did I Give Parnate Enough Time? bulldog2

Posted by doxogenic boy on August 23, 2009, at 15:26:50

In reply to Re: Did I Give Parnate Enough Time? doxogenic boy, posted by bulldog2 on August 23, 2009, at 14:57:38

> > > Are there any studies that show how nardil and parnate differ?
> > --------------
> > http://www.ncbi.nlm.nih.gov/pubmed/3295114
> >
> > J Neural Transm Suppl. 1987;23:121-38.
> > MAO inhibitors in mental disease: their current status.
> > Dowson JH.
> > "[...]
> > Tranylcypromine also merits further investigation as clinical experience suggests that it can produce a dramatic response in some patients with phenelzine-resistant disorders. This may be due, at least in part, to its amphetamine-like effects."
> > +++++++++++++++++++++++
> >
> > doxogenic
>
> Thanks.I understand ths amphetamine effect as I experienced it.But I see that as more of a side effect which tends to disappear as time goes on.
> At least it did for me.
--------------

I tried phenelzine in 2003 and it worsened my depression. The abstract I quoted from, which I have seen earlier, has made me thinking if tranylcypromine can work for me when phenelzine doesn't.
The problem is that I have tried dextroamphetamine, and the first time (with low dose escitalopram) it gave me terrible anxiety. Could I then expect tranylcypromine to increase my anxiety?

doxogenic

 

Re: Did I Give Parnate Enough Time?

Posted by bulldog2 on August 23, 2009, at 15:54:17

In reply to Re: Did I Give Parnate Enough Time? bulldog2, posted by doxogenic boy on August 23, 2009, at 15:26:50

> > > > Are there any studies that show how nardil and parnate differ?
> > > --------------
> > > http://www.ncbi.nlm.nih.gov/pubmed/3295114
> > >
> > > J Neural Transm Suppl. 1987;23:121-38.
> > > MAO inhibitors in mental disease: their current status.
> > > Dowson JH.
> > > "[...]
> > > Tranylcypromine also merits further investigation as clinical experience suggests that it can produce a dramatic response in some patients with phenelzine-resistant disorders. This may be due, at least in part, to its amphetamine-like effects."
> > > +++++++++++++++++++++++
> > >
> > > doxogenic
> >
> > Thanks.I understand ths amphetamine effect as I experienced it.But I see that as more of a side effect which tends to disappear as time goes on.
> > At least it did for me.
> --------------
>
> I tried phenelzine in 2003 and it worsened my depression. The abstract I quoted from, which I have seen earlier, has made me thinking if tranylcypromine can work for me when phenelzine doesn't.
> The problem is that I have tried dextroamphetamine, and the first time (with low dose escitalopram) it gave me terrible anxiety. Could I then expect tranylcypromine to increase my anxiety?
>
> doxogenic
>
>
>
>

I suffer from anxiety also. To my surprise parnate actually calmed me down and made me mellow and sleepy. My klonopin intake went from 2 to 1 milligrams.

 

Re: Did I Give Parnate Enough Time? bulldog2

Posted by doxogenic boy on August 23, 2009, at 16:29:07

In reply to Re: Did I Give Parnate Enough Time?, posted by bulldog2 on August 23, 2009, at 15:54:17

> > > > > Are there any studies that show how nardil and parnate differ?
> > > > --------------
> > > > http://www.ncbi.nlm.nih.gov/pubmed/3295114
> > > >
> > > > J Neural Transm Suppl. 1987;23:121-38.
> > > > MAO inhibitors in mental disease: their current status.
> > > > Dowson JH.
> > > > "[...]
> > > > Tranylcypromine also merits further investigation as clinical experience suggests that it can produce a dramatic response in some patients with phenelzine-resistant disorders. This may be due, at least in part, to its amphetamine-like effects."
> > > > +++++++++++++++++++++++
> > > >
> > > > doxogenic
> > >
> > > Thanks.I understand ths amphetamine effect as I experienced it.But I see that as more of a side effect which tends to disappear as time goes on.
> > > At least it did for me.
> > --------------
> >
> > I tried phenelzine in 2003 and it worsened my depression. The abstract I quoted from, which I have seen earlier, has made me thinking if tranylcypromine can work for me when phenelzine doesn't.
> > The problem is that I have tried dextroamphetamine, and the first time (with low dose escitalopram) it gave me terrible anxiety. Could I then expect tranylcypromine to increase my anxiety?
> >
> > doxogenic
> >
> >
> >
> >
>
> I suffer from anxiety also. To my surprise parnate actually calmed me down and made me mellow and sleepy. My klonopin intake went from 2 to 1 milligrams.
---------------

Hydromorphone (Palladon/Dilaudid) is part of my mix, could that stop eventual anxiety from Parnate?

doxogenic

 

Re: Did I Give Parnate Enough Time? doxogenic boy

Posted by bulldog2 on August 23, 2009, at 18:32:06

In reply to Re: Did I Give Parnate Enough Time? bulldog2, posted by doxogenic boy on August 23, 2009, at 16:29:07

> > > > > > Are there any studies that show how nardil and parnate differ?
> > > > > --------------
> > > > > http://www.ncbi.nlm.nih.gov/pubmed/3295114
> > > > >
> > > > > J Neural Transm Suppl. 1987;23:121-38.
> > > > > MAO inhibitors in mental disease: their current status.
> > > > > Dowson JH.
> > > > > "[...]
> > > > > Tranylcypromine also merits further investigation as clinical experience suggests that it can produce a dramatic response in some patients with phenelzine-resistant disorders. This may be due, at least in part, to its amphetamine-like effects."
> > > > > +++++++++++++++++++++++
> > > > >
> > > > > doxogenic
> > > >
> > > > Thanks.I understand ths amphetamine effect as I experienced it.But I see that as more of a side effect which tends to disappear as time goes on.
> > > > At least it did for me.
> > > --------------
> > >
> > > I tried phenelzine in 2003 and it worsened my depression. The abstract I quoted from, which I have seen earlier, has made me thinking if tranylcypromine can work for me when phenelzine doesn't.
> > > The problem is that I have tried dextroamphetamine, and the first time (with low dose escitalopram) it gave me terrible anxiety. Could I then expect tranylcypromine to increase my anxiety?
> > >
> > > doxogenic
> > >
> > >
> > >
> > >
> >
> > I suffer from anxiety also. To my surprise parnate actually calmed me down and made me mellow and sleepy. My klonopin intake went from 2 to 1 milligrams.
> ---------------
>
> Hydromorphone (Palladon/Dilaudid) is part of my mix, could that stop eventual anxiety from Parnate?
>
> doxogenic

To be honest I would tend to say no. I'm on percocet and neurontin for pain management due to severe osteoarthritis. I have a hip replacement scheduled for end of sept. I find the neurontin and percocet to have antidepressant effects which is nice but they also tend to make me feel edgey and a bit aggressive. After the operation will go to a morphine pump for several days and probably back to the percocet or some form of it.
My goal is to get off of the percocet and rely on the parnate and whatever my p-doc and I decide to augment it with.
Possibly a powerful med like parnate would allow you to discontinue the opiate? But that's up to you and your doc.
Good luck whichever path you take.

 

Re: Did I Give Parnate Enough Time? SLS

Posted by FredPotter on August 23, 2009, at 21:10:19

In reply to Re: Did I Give Parnate Enough Time? bulldog2, posted by SLS on August 22, 2009, at 18:11:18

I've read that noradrenergic TCAs like Nortriptyline make MAOIs safer

 

Re: Did I Give Parnate Enough Time?

Posted by SLS on August 24, 2009, at 5:55:20

In reply to Re: Did I Give Parnate Enough Time? SLS, posted by FredPotter on August 23, 2009, at 21:10:19

> I've read that noradrenergic TCAs like Nortriptyline make MAOIs safer

Supposedly, NE reuptake inhibitors protect a NE neuron from the uptake of excess tyramine, which is a false transmitter. Once inside the cell, tyramine accelerates the release of neurotransmitter from vesicles by displacing NE. I am not sure that the mechanism is completely understood.


- Scott


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